Behind The Knife: The Surgery Podcast

Please join Drs. Graham Skelhorne-Gross, Jordan Nantais and Ashlie Nadler from our Emergency General Surgery Team for a discussion on cirrhotic patients.   Child-Pugh Score (https://www.mdcalc.com/calc/340/child-pugh-score-cirrhosis-mortality) ·      Bilirubin, albumin, INR, ascites, encephalopathy ·      Used to predict operative mortality based on cirrhosis severity ·      Mortality in EGS: - Child-Pugh A: 10% electively and 22% emergently - Child-Pugh B: 30% electively and 38% emergently - Child-Pugh C: 80% electively and up to 100% emergently Model for End Stage Liver Disease (MELD) (https://www.mdcalc.com/calc/10437/model-end-stage-liver-disease-meld?utm_source=site&utm_medium=link&utm_campaign=meld_12_and_older) ·      creatinine, bilirubin, INR, and sodium ·      MELD < 20 – 1% increase in mortality with each point increase ·      MELD > 20 – 2% increase in mortality with each point increase Pre-operative Planning ·      Identification of cirrhosis with physical examination, bloodwork

In this episode, our team discusses the Checkmate 577 trial, the landmark paper which approved the use of nivolumab for adjuvant treatment of stage II & III esophageal & GE junction cancer. Listen as our team reviews the study population, methods and results of this trial & discusses its clinical application as well as potential areas of future research. Learning Objectives: -Review the staging and treatment of esophageal and GEJ cancer -Discuss the population, methods, and results of the Checkmate 577 trial -Understand the mechanism of action of nivolumab and the PD1 pathway -Discuss the implications of the Checkmate 577 trial in clinical practice and areas of future research Hosts: Kelly Daus MD, Megan Lenihan MD, Peter White MD, and Brian Louie MD Referenced Material https://www.nejm.org/doi/full/10.1056/NEJMoa2032125 Kelly RJ, Ajani JA, Kuzdzal J, et al. Adjuvant nivolumab in resected esophageal or gastroesophageal junction cancer. N Engl J Med. 2021;384(13):1191-1203. doi:10.1056/NEJMoa203

Please join BTK education fellow, Nina Clark, MD (University of Washington) along with Elina Serrano, MD, MPH (University of Washington) and Minerva Romero Arenas, MD (Weill Cornell Medicine) for a discussion inspired by the experience of trainees who are underrepresented in medicine.   Latino Surgical Society: https://www.latinosurgicalsociety.org/ Society of Black Academic Surgeons: https://www.sbas.net/ References:  Yeo HL, Abelson JS, Symer MM, Mao J, Michelassi F, Bell R, Sedrakyan A, Sosa JA. Association of Time to Attrition in Surgical Residency With Individual Resident and Programmatic Factors. JAMA Surg. 2018 Jun 1;153(6):511-517. doi: 10.1001/jamasurg.2017.6202. PMID: 29466536; PMCID: PMC5875388. McFarling, U.L. ‘It was stolen from me’: Black doctors are forced out of training programs at far higher rates than white residents. STAT. 6/20/2022. Accessed online: 10/1/2022. https://www.statnews.com/2022/06/20/black-doctors-forced-out-of-training-programs-at-far-higher-rates-than-white-residents/ Ha

In this episode the Endocrine Surgery team at BTK goes over two cases to review the American Association of Endocrine Surgeons Guidelines for Adrenalectomy.  Dr. Michael Yeh is a Professor of Surgery at UCLA and serves as Section Chief of the UCLA Endocrine Surgery program which he established.  Dr. Masha Livhits is an Assistant Professor of Surgery at UCLA and works in the Endocrine Surgery Department Dr. James Wu is an Assistant Professor of Surgery at UCLA and works in the Endocrine Surgery Department  Dr. Na Eun Kim is an Endocrine Surgery Fellow at UCLA in his first year of fellowship Dr. Rivfka Shenoy is a PGY-5 General Surgery Resident at UCLA who has completed two years of research  Dr. Max Schumm is a PGY-5 General Surgery Resident at UCLA who has completed two years of research. He is a future endocrine surgeon.  Important Papers  Yip L, Duh QY, Wachtel H, Jimenez C, Sturgeon C, Lee C, Velázquez-Fernández D, Berber E, Hammer GD, Bancos I, Lee JA, Marko J, Morris-Wiseman LF, Hughes MS, Livhit

In this episode the Critical Care BTK Team tackles nutrition in the ICU. High-yield journal articles will be presented, discussed, and reviewed. ICU nutrition myths will be busted, and listeners will learn about enteral nutrition, parenteral nutrition and other ICU nutrition pearls. References 1.         Casaer, M.P., et al., Early versus Late Parenteral Nutrition in Critically Ill Adults. New England Journal of Medicine, 2011. 365(6): p. 506-517. 2.         Compher, C., et al., Guidelines for the provision of nutrition support therapy in the adult critically ill patient: The American Society for Parenteral and Enteral Nutrition. Journal of Parenteral and Enteral Nutrition, 2022. 46(1): p. 12-41. 3.         McClave, S.A., et al., Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient. Journal of Parenteral and Enteral Nutrition, 2016. 40(2): p. 159-211. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos

In the third episode of the “Innovations in Surgery” series, Behind the Knife’s surgery education fellow, Dan Scheese, sits down with Adam Sachs and Dr. Igor Belyansky to discuss the current state and future of surgical robotics. They discuss the start up of Vicarious Surgical and how they are working to improve the current state of surgical robotics with their innovative ideas.  Link for the Vicarious Surgical website which includes a short video demonstration of their single port design: https://www. vicarioussurgical.com/ Adam Sachs is the CEO and Co-founder of Vicarious surgical, a surgical robotics company founded in 2014. As an MIT trained roboticist, Adam has combined his passion for robots with this passion for helping patients and enhancing the work environment for surgeons through the development of proprietary surgical robotics.  Dr. Igor Belyanksy, an internationally-recognized expert in the field of abdominal wall reconstruction and complex laparoscopic and robotic hernia repair. Dr. Belyansk

You have a patient who underwent local excision of a rectal cancer. Final pathology demonstrates a T2 lesion. What is the rate of local recurrence? Is excision alone sufficient? Should the patient undergo radical resection or should chemoradiation be offered? Tune in to find out! Join Drs. Peter Marcello, Jonathan Abelson, Tess Aulet and special guest Dr. Jose Guillem MD, MPH, MBA as they discuss high yield papers discussing local excision for Rectal Cancer. You may follow along with the slides mentioned in this episode here: https://behindtheknife.org/video/journal-review-in-colorectal-surgery-local-excision-for-rectal-cancer/ Learning Objectives 1. Describe the features that increase risk of lymph node involvement in early stage rectal cancer 2. Discuss the different options for management of early-stage rectal cancer 3. Describe patient related factors that favor local excision of rectal cancer References: Kidane B, Chadi SA, Kanters S, Colquhoun PH, Ott MC. Local resection compared with radical res

DO NOT MISS THIS EPISODE! Need a little inspiration? Tune in for Dave's story. Links from the show:  Chasing My Cure: https://chasingmycure.com/ CDCN: https://cdcn.org/ Every Cure: https://everycure.org/ AMF: https://healgrief.org/actively-moving-forward/young-adult-grief/ David Fajgenbaum, MD, MBA, MSc, FCPP, is an Assistant Professor of Medicine in Translational Medicine & Human Genetics at the University of Pennsylvania, Founding Director of the Center for Cytokine Storm Treatment & Laboratory (CSTL), Associate Director, Patient Impact of the Penn Orphan Disease Center, and Co-Founder/President of the Castleman Disease Collaborative Network (CDCN) and co-founder of Every Cure. He is also the national bestselling author of 'Chasing My Cure: A Doctor's Race to Turn Hope Into Action' and a patient battling idiopathic multicentric Castleman disease (iMCD). He is in his longest remission ever thanks to a precision treatment that he identified, which had never been used before for iMCD. He has also i

How do we actually improve wellness?  How do surgery trainees advocate for themselves as both learners and employees?  In this final surgical education episode with Matt Chia MD MS and Karl Bilimoria MD MS, we review two articles discussing unions and wellness in surgical training.  We’re joined by Meg Smith MD MS, Brian Brajcich MD MS, and Darci Foote MD MS to tackle this difficult topic and open the discussion for what’s next in surgical education. Learning Objectives: ·       Identify potential benefits and limitations of unionization in surgery training ·       Describe strategies used by program leadership to improve wellness in surgery References: National Evaluation of the Association Between Resident Labor Union Participation and Surgical Resident Well-being https://doi.org/10.1001/jamanetworkopen.2021.23412  How Program Directors Understand General Surgery Resident Wellness - https://doi.org/10.1016/j.jsurg.2022.07.022  Please visit https://behindtheknife.org to access other high-yield surgic

Join the Behind the Knife HPB team as we dive deeper into the complex world of IPMNs with a journal article review of a recent JAMA Surgery publication and the first author of the article! Learning Objectives: In this episode, we discuss the article, “Progression vs Cyst Stability of Branch-Duct Intraductal Papillary Mucinous Neoplasms After Observation and Surgery.”  This article describes a multicenter retrospective study of centers in Italy, Korea, Singapore, and the US that specifically assessed what dynamic variables are associated with malignant progression in pathologically proven IMPNs under at least a year of initial surveillance.  Hosts: Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center Daniel Nelson, DO, FACS (@DWNelsonHPB) is an Associate Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at William Bea

Our Vascular Surgery Oral Board Audio Review includes 72 high-yield scenarios that cover the majority of the VSCORE topics designed for Vascular Surgeons by Vascular Surgeons.   Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as vascular surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. Learn more about the full set of 72 scenarios here: https://behindtheknife.org/premium/vascular-surgery-oral-review/ Our Vascular Surgery Oral Board Book is available on Amazon here: https://www.amazon.com/Vascular-Surgery-Oral-Board-Review/d

Our Vascular Surgery Oral Board Audio Review includes 72 high-yield scenarios that cover the majority of the VSCORE topics designed for Vascular Surgeons by Vascular Surgeons.   Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as vascular surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. Learn more about the full set of 72 scenarios here: https://behindtheknife.org/premium/vascular-surgery-oral-review/ Our Vascular Surgery Oral Board Book is available on Amazon here: https://www.amazon.com/Vascular-Surgery-Oral-Board-Review/

Surgery is a contact sport and can cause injuries that prevent us from taking care of our patients and even threaten our careers. Join Drs. Mike Weykamp, Nicole White, Nick Cetrulo, and Andrew Wright for a discussion on the ergonomic challenges of open, laparoscopic, and robotic surgery as well as some tips, tricks, and resources on how to protect yourself and your practice.  *We apologize for some distracting background noise throughout the episode.* Referenced Articles & Websites:  1.     Wells, A. C., Kjellman, M., Harper, S. J., Forsman, M., & Hallbeck, M. S. (2019). Operating hurts: a study of EAES surgeons. Surgical endoscopy, 33, 933-940. 2.     Davis, W. T., Fletcher, S. A., & Guillamondegui, O. D. (2014). Musculoskeletal occupational injury among surgeons: effects for patients, providers, and institutions. Journal of surgical research, 189(2), 207-212. 3.     Wright, A.S. Ergonomic Injury and Surgery: The Hidden Epidemic.  Harkins Symposium at The University of Washington. October 21, 2

Vascular surgery is full of awesome anatomy and big open vessel exposures, but endovascular surgery is here to stay and can be hard to get into, particularly as a learner. The basics of endovascular surgery share very little with the basics of open surgery and getting up to speed can be a big challenge. This episode is an introduction to all things endovascular surgery, from wires, catheters and sheaths to balloons and stents. Take a listen to get up to speed quickly in prep for an upcoming vascular rotation and skip the pain of trying to follow your attendings words so you can instead pay attention to the actual case. Dr. Frank Davis is an Assistant Professor of Vascular Surgery at the University of Michigan. Dr. Craig Brown is a PGY-7 in the General Surgery program and the upcoming 2023 vascular surgery fellow at the University of Michigan. Check out the accompanying video for this episode available here: https://behindtheknife.org/video-playlists/podcast-clips/ Ad referenced in episode: A team at the

Interview season is over! There’s just one last hurdle in this residency application process to overcome- ranking and matching! Join our education fellow, Dr. Jessica Millar, and Dr. Charles Friel as they pull back the curtain on the ranking process and discuss how tooptimize your success in the match!  Guest: Charles Friel, MD- Professor of Colorectal Surgery, Surgical Director - Digestive Center of Excellence, Chief - Section of Colon & Rectal Surgery, and General Surgery Residency Program Director- University of Virginia, Charlottesville, VA “How the NRMP Matching Algorithm Works”: https://www.youtube.com/watch?v=kvgfgGmemdA&list=PLr0LH_NifZSpvQTwTqXVYn9jXfUKOTFN6&index=11 Important Dates  1.     Ranking opens 2/1 at 12PM  2.     Rank lists are due 3/1 at 9PM  3.     Match status available 3/13 at 10AM   4.     Match day results available 3/17 at 12PM EST Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this epi

In this episode, our team discusses the recent paper from JAMA Surgery Association of Whole Blood With Survival Among Patients Presenting With Severe Hemorrhage in US and Canadian Adult Civilian Trauma Centers. Join us as we explore some of the history of blood transfusions, how we got to where we are today, and the role whole blood transfusion may play going forward Hosts:  Elliott R. Haut, MD, PhD, a senior, nationally recognized name in trauma and acute care surgery at Johns Hopkins University. Dr. Haut is a past president of The Eastern Association for the Surgery of Trauma (EAST) and editor-in-chief of Trauma Surgery and Acute Care Open. Marcie Feinman, MD, MEHP, the current program director of General Surgery Residency at Sinai Hospital of Baltimore and editorial board member of SCORE. She received her Masters in Education in the Health Professions from Johns Hopkins.  David Sigmon, MD, MMEd, a PGY-7 resident at the University of Illinois at Chicago who will be a fellow at Lincoln Medical Center in t

**Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions.

Join Patrick Georgoff and Kevin Kniery for a special conversation with the king and queen of medical comedy Dr. Will Flanary, aka Dr. Glaucomflecken (@drglaucomflecken), and Kristin Flanary, aka Lady Glaucomflecken (@Lglaucomflecken).  Will is a practicing ophthalmologist and social media personality with over 4 million followers. During his 3rd year of medical school, he was diagnosed with testicular cancer, and he began using humor as a coping mechanism. Following a second bout with cancer three years into his medical career, he created a Twitter account under the pseudonym "Dr. Glaucomflecken"— because it is arguably the funniest word in ophthalmology. A cardiac event and near-death experience in 2020 only fueled his creativity. Kristin is formally trained in cognitive neuroscience and social psychology and now works in marketing and communications. Kristin is best known internationally as her social media alter ego, “Lady Glaucomflecken,” where she shares stories from her unique perspective of the health

Did you miss this year’s Eastern Association for the Surgery of Trauma meeting?  Don’t sweat it!  Behind the Knife has got you covered.  In this episode we discuss “Scientific Papers that Should Change Your Practice” with EAST manuscript and literature committee members Drs. Laura Brown (@laurarbrownMD), Brittany Bankhead (@bbankheadMD), and Julia Coleman (@juliacolemanMD).   Universal blunt cerebrovascular screening?  Early renal replacement therapy?  Artificial intelligence in emergency general surgery?  This episode is PACKED with high-yield material.   To learn more about all the good things happening at EAST visit www.east.org.  Papers discussed:  1.     Do not forget the platelets: The independent impact of red blood cell to platelet ratio on mortality in massively transfused trauma patients (https://pubmed.ncbi.nlm.nih.gov/35313325/) 2.     The 35-mm rule to guide pneumothorax management: Increases appropriate observation and decreases unnecessary chest tubes (https://pubmed.ncbi.nlm.nih.gov/3512544

Please join Drs. Brian Gray, Amanda Jensen, and Manisha Bhatia from Indiana University as they discuss Hirschsprung disease in regard to variability of the transition zone and surgical operative and pathologic diagnosis reporting in pediatric surgery. Journal Article links:  Veras LV, Arnold M, Avansino JR, Bove K, Cowles RA, Durham MM, et al. Guidelines for synoptic reporting of surgery and pathology in Hirschsprung disease. J Pediatr Surg 2019;54(10):2017-23. https://pubmed.ncbi.nlm.nih.gov/30935730/ Thakkar HS, Blackburn S, Curry J, De Coppi P, Giuliani S, Sebire N, et al. Variability of the transition zone length in Hirschsprung disease. J Pediatr Surg 2020;55(1):63-6. https://pubmed.ncbi.nlm.nih.gov/31706615/ Coyle D, O'Donnell AM, Tomuschat C, Gillick J, Puri P. The Extent of the Transition Zone in Hirschsprung Disease. J Pediatr Surg 2019;54(11):2318-24. https://pubmed.ncbi.nlm.nih.gov/31079866/ **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindthek